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Radiofrequenzablation als palliative Therapieoption bei HNO-Tumoren

In-vivo- und In-vitro-Versuche

Radiofrequency ablation as a palliative therapy option in ENT tumors

In vivo and in vitro testing

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Zusammenfassung

Hintergrund

Die transkutane Hochfrequenzthermotherapie (HfTT) oder Radiofrequenzablation (RFA) ist als palliative Therapie bei Malignomen der Leber etabliert. Eine In-vitro- und In-vivo-Studie soll die Voraussetzungen zur Anwendung der RFA mit flüssigkeitsgekühlten Elektroden zur minimal-invasiven, palliativen Therapie von Kopf-Hals-Tumoren untersuchen.

Material und Methoden

Mit durch Perfusion mit isotonischer Kochsalzlösung gekühlten Nadelelektroden wurde mit dem Hochfrequenzapplikator (Elektrotom HiTT 106, Fa. Berchtold, Tuttlingen) bei frischen Schweinezungen und juvenilen Hausschweinen die RFA in Zunge und Halsweichteilen unter Echtzeitkontrolle mittels B-Mode-Ultraschall für 2 bzw. 3 min bei einer Leistung von 60 W angewendet.

Ergebnisse

Die Richtung der Ausbreitung der Hyperthermiezone lässt sich mittels Ultraschall gut beobachten. Die Steuerung der Ausbreitungsrichtung ist bei flüssigkeitsgekühlten Nadelapplikatoren nicht möglich. Schwerwiegende Akutkomplikationen wurden nicht beobachtet.

Schlussfolgerung

RFA mit flüssigkeitsgekühlten Nadelapplikatoren lässt sich im Kopf-Hals-Bereich nicht kontrolliert als palliative Therapie einsetzen.

Abstract

Background

High frequency thermotherapy (HFTT) is an established palliative therapy for hepatic malignancies. An in vivo and in vitro trial examined the preconditions for the application of HFTT with liquid-cooled wet electrodes for minimally invasive palliation of head and neck tumors.

Material and Method

HFTT was applied with needle electrodes, cooled with isotonic saline solution, and a high-frequency generator (Elektrotom HiTT 106, Berchtold, Tuttlingen) to porcine tongue and narcotized, juvenile domestic pigs to the tongue and neck, and monitored in realtime by B-mode ultrasound.

Results

The direction of spread of the hyperthermic zone is well observed using ultrasound. Determining the direction of spread is not possible with cooled-tip electrode needles. Severe complications were not observed during the application.

Conclusion

RFA with liquid-cooled needle applicators is not safely applicable for the therapy of head and neck tumors.

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Authors and Affiliations

  1. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland

    S. Bucher, J. Hornung, V. Bonkowsky, H. Iro &  J. Zenk

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  1. S. Bucher
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  2. J. Hornung
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Correspondence to J. Zenk.

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Bucher, S., Hornung, J., Bonkowsky, V. et al. Radiofrequenzablation als palliative Therapieoption bei HNO-Tumoren. HNO 58, 358–363 (2010). https://doi.org/10.1007/s00106-009-2067-0

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